Hepatitis A epidemics that have lasted for months in Malappuram, Kozhikode and Ernakulam districts are still going on with new cases being reported. Infections are on the rise in Kerala, however, during all of July and August when the Nipah outbreak occurred in Malappuram and landslides hit Wayanad few weeks earlier.
But this year (2024), water-borne diseases such as cholera and hepatitis A alongside vector-borne disease is also spreading into many districts.
New cases continue to be reported daily about this Hepatitis A epidemic that began months ago in Malappuram district, Kozhikode district and Ernakulam district. This water borne illness has been devastating in Kerala this year due to its association with unsafe drinking water.
Throughout the year, Kerala has had numerous large outbreaks of hepatitis A along with deaths. In every year, two times more probable or epidemiologically-linked-but-not-confirmed cases than confirmed cases are detected.
In 2024 alone, 1,073 people in Kerala were confirmed to have contracted Hepatitis A. A previous year (2022) there were 231 confirmed cases while probable infections were 894. Only two people died as a result of it being verified.
However, even before the monsoon set in explosive outbreaks came from Ernakulam, Malappuram, Kannur and Thrissur among other districts last year.
As on August 21st 2024, Kerala had reported 4306 confirmed Hepatitis-A cases and a further 12958 suspected ones.i.e., a total number of 544 suspectd cases but only one was proved confirmatory. Hundreds of adults who got affected by hepatitis had to spend amounts ranging between thousands of Rupees for medication till date they have not yet recovered fully from the sicknesses that they experienced
A study done earlier in Kerala shows that the average amount spent by a family as out of pocket expenditure with regards to one adult member being infected with hepatitis A is approximately ₹25,000.
Clean drinking water
It is quite alarming that a state which boasts of being the finest in matters relating to public health having received several national accolades for this matter has been paying so little attention to one of the basic social determinants of health such as access to safe drinking water.
The responsibility for providing safe drinking water does not lie with the Health department though, yet both local self-governments and Kerala Water Authority (KWA) have ignored this. All these outbreaks occurred in rural areas only, and were connected to local source of drinking water, like wells and regional water supply schemes.
Dengue, leptospirosis cases
Kerala was anticipating an explosive outbreak of dengue fever this year based on early disease transmission trends. However, the statewide heavy rainfall has mitigated it somewhat. As at August 21st however, there have been 13,948 confirmed cases and a further 37,735 probable cases of dengue fever reported from various parts of the State. Nonetheless, there have been 54 deaths because of dengue fever that were confirmed and forty others that are still probable up till now.
Leptospirosis burden has increased over time in Kerala leading to this year’s documented figure i.e., 1916 confirmed along with 1565 suspected cases as on August 21. There are already 120 confirmed deaths and another 102 probable ones registered so far.
According to public health experts, the peak should be past in another month yet the case graph does not show any signs of going down. There could be complexities of changing weather patterns and environmental issues that are complicating incidences of leptospirosis which has always had a steady pattern of incidence in Kerala.
For several decades now, the State has been grappling with dengue and leptospirosis epidemics on an annual basis where reducing mortality has been emphasized lately. Nonetheless, this goal is being defied by failures to diagnose early atypical presentations of infections as well as deficiencies in public sector hospitals ability to cope with acute complications due to dengue and leptospirosis.
